Provider Demographics
NPI:1255407516
Name:BRAMMER, ROBERT (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:BRAMMER
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 MEADOW VIEW DR
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-8211
Mailing Address - Country:US
Mailing Address - Phone:509-963-3629
Mailing Address - Fax:
Practice Address - Street 1:6900 W INTERSTATE 40 STE 190A
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2525
Practice Address - Country:US
Practice Address - Phone:806-676-2539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14622101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX60054OtherAETNA
TXBLUE CROSSOther3785 LC